Our latest guest blog post is by Curtis Parker-Milnes from Leeds Cancer Centre. He talks about how he became interested in therapeutic radiography, his specialist role in quality and safety and making a difference to patients.
Hello, my name is Curtis. I’m the radiographer writing your blog today. I currently work at the Leeds Cancer Centre as a specialist therapeutic radiographer, where I focus my extra efforts on quality and safety in radiotherapy. It’s not as dull as it sounds! After three years of hard work I graduated from Sheffield Hallam University in 2015 and dived straight into work here. In September 2017 I applied for a new position as a specialist radiographer and made the move upwards in November.
I spend the majority of my time working clinically but I gratefully receive two “non-clinical days” per month to focus on aspects of my specialism. My day-to-day job is largely the same as many other therapeutic radiographers - I aim to deliver high quality care and accurate treatment using high energy X-rays. I’m sure colleagues will rib me for being quite so cheesy but I really do enjoy making people smile. Despite having no children, I've mastered the art of the ‘Dad joke’.
As alluded to in the last blog by Jo McNamara, I also “stumbled” into radiotherapy. I was well aware that I was keen to work in a hospital environment, doing something to help somebody, I just wasn’t sure what that was. One day at school I was flicking through the online UCAS catalogue, postulating whether agriculture and farming was for me. As you’re now reading this, I think you know the answer to that one. I eventually found “Cancer”, clicked through, found out about therapeutic radiography and I have never looked back. And there is a reason I clicked that cancer button…
At the ripe-old age of fourteen I was diagnosed with a Wilms’ tumour, obviously a big shock to me and my family. After a nephrectomy (kidney removal) and weekly chemotherapy for a shade over six months I was advised that treatment had been successful. Note I am careful to avoid using the phrase “beat cancer”. Battling cancer metaphors may be useful for some, but not me. Kate Granger wrote very eloquently about this in 2014. Cancer isn’t a fight. I didn’t act bravely. Those I know who have died aren’t losers, they aren’t weak. Cancer can be a very defining point in people’s lives - I certainly see my life as biphasic. There’s pre-cancer and post-cancer. Thankfully, the post-cancer phase continues to get longer.
I have an affinity for dogs - if I was to describe my professional self as a dog I would be a Labrador like Alfie (pictured). Sniff stick, sniff flower, chase ball, stop chasing ball to scratch ear, continue chasing ball. There are lots of things I currently do in addition to delivering treatment; I’ve recently finished a project to transfer all of our local error reporting from paper-based to electronic. Not only are we saving trees and making it easier for our deputy manager who deals with the error reports, but we are also seeing an increase in the number of errors reported. This is not a bad thing - it shows a healthy reporting culture.
All radiotherapy errors are stratified into five levels. Level 1 errors are "reportable radiation incidents", the most serious but thankfully most infrequent errors. Level 5 errors are “non-conformances”, minor issues which have no bearing on treatment delivery. To put this into context, on a national level fewer than 1% of all errors reported in 2017 were level 1 errors.*
An error report is not a tool to beat someone with (in particular because it’s now digital!) but it should be used to supplement learning and improve our processes. These error reports allow us to sit down and discuss what happened and how we can minimise that happening again. In August, 80 errors were reported, the vast majority were level 5 and none resulted in any harm.
Another job I have got myself doing is organising our annual open day - this year it’s Saturday 13th October. There will be a tour where visitors can travel the patient pathway, from pre-treatment and radiotherapy planning, to treatment delivery and machine maintenance. Previous patients have kindly agreed to share their experiences too. My friend Sarah Underwood, is a graphic designer and very kindly made us a poster for the event drawing a lot of positive reactions from my colleagues.
I am also leading on a safety project to ensure that treatment accessories are always used at the right time. We will be using barcode scanning to check the correct usage of the accessories. Work with this project is going well and I am very excited for this to be implemented. However that will be far from my proudest achievement.
My mental health has fluctuated a lot over the past year and a half and I have noticed myself becoming acutely aware of patients who may need a little bit more support. Sometimes this is a formal process with our patient support team or it can be more informal. Very recently I noticed someone who, without probably realising it, was reaching out for a little bit of help. So I offered that help. A colleague swapped in for me so patients could continue receiving treatment and myself and the aforementioned patient sat together and talked; we put the world to rights. We talked about how rubbish men can be, how scary the thought of returning to work can be. Moreover, we talked of the terrifying realisation of having the safety net removed when treatment finishes and hospital visits become infrequent. I asked her to trust me that it will be okay, because I know.
On her last day she brought a card in just for me. I will refrain from sharing the contents of the card but it made me feel very special, very warm and very happy. It’s moments like this that remind me how important our job is, how much trust our patients put in us and how we can enhance their lives. One thing that everyone should appreciate is that this can work in the opposite way too.
* Figures compiled from 2017 triannual reports: Gov.uk (2018) Safer radiotherapy: error data analysis. Available online: https://www.gov.uk/government/publications/safer-radiotherapy-error-data-analysis-report